At Last – A Treatment For Jaw Osteonecrosis

Osteonecrosis mandible from mostly IV biphosphamates can be a real hazard in cancer treatments – now it looks like teriparatide – human recombinant pararthyroid hormone peptide 1-34 – was able to help recovery

“78-year-old osteoporotic woman with osteonecrosis of the mandible related to alendronate therapy”

“daily subcutaneous injection of 20 microg teriparatide, as usually recommended for treatment of osteoporosis”

“RESULTS.: The oral mucosa completely regrew, and pain subsided 4 weeks after the initiation of teriparatide administration. Progressive bone regeneration was found during and after the 6-month period of teriparatide therapy”

Comment – looks great but debridement is necessary to area. Won’t be cheap.

addendum:

There is evidence that drugs like pamidronate allow bacteria to stick to bone better and cause an osteomyelitis:

“Preoperatively antibiotics were given intravenously for a median of 1 to 3 days and after operation for a median of 7 days
(Table 3). After discharge from hospital, oral antibiotic therapy followed. “

“Sutures were removed after the 14th day if necessary. Sutures that could not be removed easily were left for self-resorption.”

“In addition, chlorhexidine mouth rinses 0.12% (CHX) once a day were recommended.”

“median duration of preoperative antibiotic therapy was 31 days (23 to 54 days) orally and 1 day intravenously (1 to 3 days). Postoperatively,
the patients received antibiotics intravenously for 7 days (3 to 14 days) and afterward orally for another 12 days (5 to 47 days;”

Comment – there is strong usage of sultamicillin (a peniciliin plus a beta-lactamase inhibitor)- a Phizer product Unasyn that ?could be gotten by emergency release though I did find an out of country site for purchase:http://www.rxheads.com/unasyn-oral-p236